Nursing Student Assistance Request
Please complete this form to request assistance from instructors or fellow students. Provide as much detail as possible to ensure we can connect you with the right support.
Full Name
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First Name
Last Name
Email Address
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example@example.com
Phone Number
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Please enter a valid phone number.
Format: (000) 000-0000.
What Area Do You Need Help With?
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Please Select
Dosage Calculations
Med-Surg
Fundamentals
Pediatric
OB/Maternity
Pharmacology
Care Plans
NCLEX Prep
Other (please specify)
Additional Details/Specific Problems
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Provide more details about your assignments, topics, or areas where you need extra guidance. Include any examples or problems you’re struggling with.
Select Date and Time Slot for Assistance
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Upload Relevant Course or Assignments
Upload a File
Drag and drop files here
Choose a file
Please attach any files that will help me understand your needs. Do not include patient information or charts — submissions with patient info will be canceled.
Cancel
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By submitting this form, you acknowledge that the information provided may be shared with instructors for tutoring or care plan assistance. Do not include any personal patient information, charts, or identifiers. All submitted information will be treated confidentially and handled in accordance with HIPAA guidelines to protect student and patient privacy.
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Submit Request
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